Milan, Italy, 7 - 10 May 2011

Not just Lake Malawi. Katayama fever at the Hospital of Tropical Diseases, London, UK, over the last 12 years

Abstract number: P876

Logan S.A., Nebbia G., Armstrong M., Whitty C., Doherty T.

Objectives: Our objective was to describe epidemiological and clinical features of Katayama Fever in the era of improved serological testing for Schistosomiasis.

Methods: We performed a retrospective review of cases of Katayama Fever that have been seen over the last 12 years at the Hospital for Tropical Diseases, London, UK. We identified patients from a specifically designed database of all cases of Schistosomiasis as well as searching through the hospital inpatient and outpatient databases and our own personal records.

Results: We have complete data on 57 patients from 1998 to 2008. We will have further data on at least a further 8 patients prior to May 2011. 73% (42) are male and the median age at presentation was 27 years (range 1960 years). Only 38% had been to Malawi though all reported freshwater exposure. With the exception of one all had been to Africa. Swimming on holiday was the main reason for exposure in 56% of patients. The others were either expatriates or on business trips. Time from exposure to symptoms was established in 32 patients and the median was 6 weeks. The diagnosis was made on the clinical presentation. Eosinophilia was present in 79% of patients though interestingly 12 patients presented with a normal count which subsequently increased. Schistosomal serology was positive in 91% of patients. This was tested in all patients within 12 weeks of their exposure. The majority were tested at the time they had symptoms of Katayama fever. Only 10% of patients had detectable ova in their urine or stool. All were treated appropriately with praziquantel and had a good clinical outcome.

Conclusions: Exposure to Schistosomiasis occurs thoughout Africa, not just Lake Malawi. Katayama Fever should be considered in patients presenting with any of the typical features. A normal eosinophil account does not preclude the diagnosis. The serology is positive in the majority of patients at the time of their symptoms.

Maps, tabular presentation of the clinical features with the additional patient data incorporated and a graphic of the Schistosomiasis life cycle will form part of the poster presentation.